Rheumatic fever: the way it was.

Familial Aggregation of Aortic Valvular Stenosis

“…At the onset of the 20 th century, the most common cause of aortic valve disease was rheumatic fever, largely a disease affecting the young following a streptococcal infection. 34 Rheumatic fever is however quite uncommon in modern Sweden as recently described by our group 5 and unlikely to have influenced the results in our study. Immigration from countries where rheumatic fever remains endemic was also limited to Sweden during the study period.…”

Rheumatic fever and rheumatic heart disease a historical perspective

“…In the USA in the 1920s, RF was the leading cause of death in individuals between 5 and 20 years of age and was second only to tuberculosis in those between 20 and 30 years. [2] The only treatment was salicylates and bed rest. The majority remained at home for weeks, more often for months, with a smoldering illness; in the USA and Europe, the sicker children were managed in foster homes or special institutions for the chronically ill.[2]…”

What Killed Mozart?

“…34 Death generally occurs from chronic valvular damage that becomes clinically apparent years to decades after the original episodes. 45,46 In acute attacks, the earliest mortality rates recorded, from the middle to late 19th century, were only 1% to 5%, even among those ill enough to require hospitalization. 47 Acute rheumatic fever, therefore, fails to explain several features of Mozart's illness.…”

“…Certainly, he might have had subclinical valve damage detectable only with auscultation, a technique unavailable then. Those who died of acute rheumatic fever, however, usually already had severe heart disease, 45,46 something that Mozart's previous physical vigor discounts.…”